| NPI | 1558711440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 1014848) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 65355) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2023-06-29 |